| Submitted by: | Gordon Irlam |
| Date: | 2015-09-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2015-GRICF-03 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2015-07-05 | Health | Insurance | $597.00 |
| 2015-07-08 | Health | Dentist | $1450.00 |
| 2015-07-16 | Health | Group | $110.00 |
| 2015-07-16 | Health | Therapy | $185.00 |
| 2015-07-24 | Health | Prescription | $54.65 |
| 2015-07-28 | Health | Dentist | $1450.00 |
| 2015-08-05 | Health | Insurance | $597.00 |
| 2015-08-13 | Health | Therapy | $185.00 |
| 2015-09-05 | Health | Insurance | $597.00 |
| 2015-09-10 | Health | Periodontist | $160.00 |
| 2015-09-15 | Health | Dentist | $1170.00 |
| 2015-09-19 | Health | Group | $270.00 |
| 2015-09-24 | Health | Therapy | $185.00 |
| Total expenses | $7010.65 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $7010.65 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.56/mile, lodging, M&IE |
Signature:
| Approved by: | Purobi Phillips |
| Signature: | |
| Date: |